This doctor has a system

Chapter 461 525. Misdiagnosis? Lung cancer? (Thanks to the 16888 tip from my brother who has been losing weight. It’s very auspicious.)
It was at this time that Gao Feng and his party arrived at the state hospital.

"This is really hard to explain, but the imaging is very consistent with the manifestations of tuberculosis." Professor MacPhail looked at the chest CT results and fell into deep thought.

However, after taking anti-tuberculosis drugs for so long, there is no absorption on imaging, which is puzzling.

"If you can't do it, let's get a bronchoscope." Everyone discussed it.

Effie Richard was a little hesitant. His wife had a slightly special constitution. She was allergic to anesthetics during a gastrointestinal endoscopy, which scared him half to death.

"Local anesthesia can also be used, or no anesthesia can be used at all." Professor MacPhail suggested.

"I need to ask for her own opinion," Effie Richard said at last.

"My friend, why are you here?" Prampedi stepped forward and hugged Effie Richard, "Is there something wrong with your health?"

"No." Seeing a smile on the face of his old friend Effie Richard, "It's my wife Mary. She's a little uncomfortable."

The two exchanged pleasantries, and Pulan Peidi introduced Gao Feng to him.

"This is Gao Feng from China, whom you praised before." Professor MacPhail explained, "It's the hard-scope operation video that we have all seen."

"Are you thinking it's a tumor?" Professor MacPhail asked, "Why do you say that? We just discussed it and feel that infection is still more likely."

However, considering the national conditions and population base, it is acceptable.

Think about the number of outpatient visits by domestic doctors
"What's going on? Why did Professor Phil bring a Chinese here? And you want him to participate in the next bronchoscopy?" A middle-aged man wearing black-rimmed glasses said dissatisfied, "This does not comply with the regulations! "

That is to say, thanks to the rapid development of current anesthesia technology, we can enjoy the convenience of painless surgery.

"Mr. Richard, can I see your wife's chest CT?" Gao Feng said.

The speaker was Milchester, manager of the bronchoscopy suite at the State Hospital.

"Thank you." Gao Feng said.

In fact, bronchoscopy did not require anesthesia at the beginning, and it used a rigid scope. You can think about the pain that the patient has to endure.

This left Effie Richard indecisive and in a dilemma.

"Okay, this is it." Professor MacPhail stood up and made room without thinking much, but he always felt that the name Gao Feng was somewhat familiar.

However, without anesthesia, bronchoscopy while awake is more painful. His wife Mary made it clear that she felt she couldn't bear it.

"Huh?" Effie Richard exclaimed.

Milchester thought the other party was perfunctory and refused to give in. "This is different. The others are all well-known scholars," he said.

"Only 200 cases?" Gao Feng was stunned for a moment, that's too few! There is no exception in one day
You must know that the Provincial People's Hospital does at least 7000 cases a year, and the First Affiliated Hospital only does a lot more.

But life is important, and there is nothing you can do if you don't endure it at the critical moment. How can you be so delicate when you are sick?

"you?"

Effie Richard admires and admires Gao Feng's scientific research ability, but he does not have high hopes for clinical level. As we all know: scientific research and clinical practice are two completely different things.

"Gao Feng is a doctor of respiratory medicine." Prampedi explained, he just remembered it.

"Have you considered it to be a tumor?" he asked.

"You are Gao Feng! That Gao Feng from China?!" Professor MacPhail suddenly said, "I know you!"

But by coincidence, Mary's chest CT image was displayed on the computer in front of Professor MacPhail.

"Phil, this is Gao Feng scholar from China. He wants to see my wife's chest CT scan."

In this case, a bronchoscopy should be performed as soon as possible. According to Gao Feng's experience, tumor tissue should be visible under the microscope.

"Look, the seepage here is very consistent." He talked a lot to Gao Feng.

Effie Richard was slightly surprised to see Professor MacPhail chatting happily with Gao Feng. As far as he knew, although MacPhail usually seemed approachable, he was actually a very arrogant person.

It seems that Gao Feng, who comes from China, must have something he doesn't understand.

Gao Feng stepped forward and carefully pulled the mouse. He carefully compared the images of the lung window and the mediastinal window, and frowned. This didn't look good.

"The lesions should be visible in the lumen. You can try it even without anesthesia." Gao Feng said.

"Professor Gao Feng, are you interested in participating?" MacPhail invited him. "The level of bronchoscopy in the state hospital is still very good. We have many experienced operating doctors here."

Professor MacPhail only sees 4-8 patients a day, which he says consumes most of his energy.

"Thank you for your compliment." Gao Feng said.

"I know you are an extremely outstanding Chinese scholar. Your articles have been praised by many scholars." Effie Richard shook hands with Gao Feng, "I will recommend you to other people on the selection committee."

He stepped forward and shook hands with Gao Feng, "I've seen your hard mirror operation video, and you did a very good job!"

"This is the situation. MacPhail suggested that we do a bronchoscopy." Effie Richard glanced at his wife distressedly, "You know, Mary had allergies when she had a gastrointestinal endoscopy before. If anesthesia is used, there will be risks. Somewhat big.”

"At least 200 operations are performed here every year."

"No, no, the morphological characteristics of this place are not consistent with inflammation." Gao Feng said, "It should be that the tumor is combined with infection."

But in fact, many scholars have visited state hospitals, and there are many hands-on practices here.

Prampedi is also very familiar with Effie Richard's wife Mary. Since they have come to the hospital, it is natural to visit them.

But the other party has proposed it, and it is obviously difficult to refuse. So Effie Richard led Gao Feng and others to the doctor's office.

"What's the discrepancy?" Professor MacPhail was obviously unhappy. "Professor Gao Feng is the scholar I invited to visit. He is just assisting me."

"This and that won't work either!" Milchester said. He glanced at the young Gao Feng, his eyes full of distrust.

"Okay, I can do it myself!" Professor MacPhail was very dissatisfied, but he had no other choice. In the bronchoscopy room, Milchester had a greater say than him. many.

"Sorry, Professor Gao Feng."

"It's okay." Gao Feng smiled. In fact, he just came to visit and didn't really want to do anything. After all, this was a bit simple and it was difficult to arouse his interest.

On the other hand, Li Youliang on the side was a little unhappy, "There is something wrong with these four eyes." He was worried that the other party could not understand Chinese and spoke in a low voice. Gao Feng glared at him.

Generally speaking, the bronchoscopy operation procedures in state hospitals are similar to those in Provincial People's Hospital, and the preparation work in the former is even simpler.

In provincial hospitals, nurses will routinely inhale oxygen and connect ECG monitoring to patients who are not under general anesthesia, but state hospitals do not require this procedure.

Gao Feng guessed it was because the guards in the hospital were equipped with guns and because there were few medical incidents abroad.

Professor MacPhail carefully picked up the bronchoscope and inserted it through the patient's nostril. He tried to keep his movements gentle to reduce the patient's discomfort.

But in Gao Feng's view, the opponent's bronchial operation skills were average, probably because he didn't do much at ordinary times.

If you don't do one example a day, there will be no monsters to defeat, and the experience bar will naturally not be accumulated.

"Okay, take a deep breath!" Professor MacPhail said to the patient. This is a critical step. When the patient takes a deep breath, the glottis is open. At this time, he can take the opportunity to put the mirror into the airway.

The patient quickly took a deep breath after hearing this, and the bronchoscope entered the airway smoothly. Now everyone had a relaxed smile on their faces.

As the mirror moves downward, the scene inside the airway is also exposed to everyone.

"This is tumor infiltration..." Professor MacPhail said.

Under the microscope, it can be seen that the middle lobe bronchus of the right lung is stenotic and polypoid neoplasms protrude into the cavity, which are very typical manifestations of lung cancer.

"You need to hold on a little longer, we're going to take a biopsy," Professor MacPhail said to the patient, who blinked.

Effie Richard also walked in at this time. According to regulations, the patient's family members were not allowed to enter at this time. But again, rules are designed to be violated.

The four-eyed Milchester also smiled at him, which made Li Youliang, who was paying attention to him, roll his eyes. This stupid foreigner doesn't follow the rules now!
How abominable!

"Oh my God!" Effie Richard looked frustrated. Although he was not a respiratory physician, he was still a medical researcher after all. After seeing the situation under the mirror, he no longer needed anyone to say anything to him.

Professor MacPhail took the biopsy forceps handed by the nurse, inserted it and began to adjust the position of the bronchoscope. He moved the mirror back a bit, and then began to extend the biopsy forceps.

Gao Feng shook his head subconsciously, this angle was not good.

Sure enough, when the pliers were stretched underneath and opened, the new polyp-like creature could not be reached at all.

Professor MacPhail adjusted the angle again, and this time the position was correct, but the patient was breathing heavily and coughing from time to time.

"Professor, there's no way to clamp it." The nurse on the side frowned. They basically perform general anesthesia when taking biopsies here, and only use local anesthesia for routine examinations.

Nurses also don’t like to perform local anesthesia. The patient suffers more pain. There will always be things like this during the examination, which is more troublesome.

"Try again." Professor MacPhail said, "Hold on, take a deep breath, and try not to cough." He lowered his head and said to the patient.

Obviously, this is just wishful thinking on his part.

This is like someone stabbing you with a knife and then saying: Be good, it doesn't hurt, hold on, we can't scream!

Mary couldn't control herself at all, and the bronchoscope shook back and forth in her airway, which was very uncomfortable.

"Milchester, it's your turn." Professor MacPhail tried twice more and failed.

"Me?" Milchester was stunned for a moment.

"Yes, your level must be better than mine." Professor MacPhail handed him the mirror in his hand, "Hurry up, Mary can't hold on anymore."

Damn it, you admit that my level is too high at this time, Mirchis cursed in his heart.

However, in Gao Feng's opinion, his proficiency did exceed Professor MacPhail, but only a little.

Milchester tried twice, but was a little helpless. "Let's switch to general anesthesia," he suggested.

At this time, the mirror had withdrawn, and Mary quickly sat up and gasped for air.

"Oh God, I almost died just now!" She said in shock: "It's like choking on a hot pepper, it's very uncomfortable!"

Effie Richard quickly stepped forward to comfort him.

Everyone discussed in a hurry for a long time and decided to call an anesthesiologist over.

"Let me try." Gao Feng said at this time.

"Gao, it's too laborious to perform a biopsy under local anesthesia!" Professor MacPhail said, "We really need an experienced anesthesiologist."

"Actually, it's not that difficult." Gao Feng considered, "I think as long as the angle is adjusted properly, simply taking a biopsy is quite easy."

Arrogant Chinese! Mirchis on the side had an unhappy face. He couldn't get up, so how could this young man with no hair on his mouth be able to?
He admitted that the other party's treatment operation under the hard microscope was very good, but it was under general anesthesia, so it was easier to operate without moving!
In order to teach this young man a lesson, he did not yell about any rules this time.

"Everyone, please rest assured that Professor Gao is the best doctor in our hospital for performing bronchoscopy." Li Youliang said in his broken English, "Our hospital performs more than 7000 cases of bronchoscopy every year, and biopsy under local anesthesia is not uncommon. ”

"So many?!" Professor MacPhail was severely shocked.

Gao Feng put on his gloves, quickly picked up the bronchoscope and inserted it in. It is said that laymen watch the excitement, while experts watch the door. His silky and smooth operation made everyone shine.

Whether you have skills or not, you generally can’t deceive people.

Instead of instructing the patient to take a deep breath like Professor MacPhail, the high-wind operation bronchoscope naturally entered the airway.

This is a technique that does not require the patient to cooperate deliberately, but caters to the patient. This technique can only be mastered after doing it a lot.

The state hospital only performs more than 200 cases of bronchoscopy a year, and Gao Feng does not expect them to master too many skills.

This is often the case. Foreign scholars invent a surgical operation, but it is often Chinese scholars who can really promote this surgical operation.

Without him, it was fed by a large number of patients.

Under the high wind operation, the bronchoscope moved steadily in the center of the airway, which greatly reduced the irritation to the airway mucosa. At this time, Mary's breathing was much calmer, and there was almost no coughing.

"Pliers." Gao Feng said. After taking it, he internally rotated his left wrist about 45°, and then pushed the mirror forward 1 centimeter. "Okay, open it."

The nurse quickly pushed it with her thumb, and the biopsy forceps opened smoothly. After waiting for about 3 seconds, Gao Feng pushed the mirror forward a little more, and the biopsy forceps immediately attached to the new polyp-like creature.

(End of this chapter)